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| Plan Name | REVOLUTION BUSINESS SERVICES LLC |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | REVOLUTION BUSINESS SERVICES LLC |
| Employer identification number (EIN): | 843766818 |
| NAIC Classification: | 561300 |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2022-01-01 | JESICA HURSTEL | 2023-05-01 | ||
| 501 | 2021-01-01 | JESICA HURSTEL | 2022-05-26 | ||
| 501 | 2021-01-01 | JESICA HURSTEL | 2022-06-29 | ||
| 501 | 2020-01-01 | JESICA HURSTEL | 2021-06-07 |
| 2022: REVOLUTION BUSINESS SERVICES LLC 2022 form 5500 responses | ||
|---|---|---|
| 2022-01-01 | Type of plan entity | Mulitple employer plan |
| 2022-01-01 | Plan funding arrangement – Insurance | Yes |
| 2022-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2021: REVOLUTION BUSINESS SERVICES LLC 2021 form 5500 responses | ||
| 2021-01-01 | Type of plan entity | Mulitple employer plan |
| 2021-01-01 | Submission has been amended | Yes |
| 2021-01-01 | Plan funding arrangement – Insurance | Yes |
| 2021-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2020: REVOLUTION BUSINESS SERVICES LLC 2020 form 5500 responses | ||
| 2020-01-01 | Type of plan entity | Mulitple employer plan |
| 2020-01-01 | First time form 5500 has been submitted | Yes |
| 2020-01-01 | Plan funding arrangement – Insurance | Yes |
| 2020-01-01 | Plan benefit arrangement – Insurance | Yes |
| CALIFORNIA PHYSICIANS SERVICE (National Association of Insurance Commissioners NAIC id number: 61557 ) | |||||||||||||||||||||||
| Policy contract number | W0051268 | ||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||
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| BLUE SHIELD OF CALIFORNIA LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61557 ) | |||||||||||||||||||||||
| Policy contract number | W0051268 | ||||||||||||||||||||||
| Policy instance | 2 | ||||||||||||||||||||||
| |||||||||||||||||||||||
| CALIFORNIA PHYSICIANS SERVICE (National Association of Insurance Commissioners NAIC id number: 61557 ) | |||||||||||||||||||||||
| Policy contract number | W0051268 | ||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||
| BLUE SHIELD OF CALIFORNIA LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61557 ) | |||||||||||||||||||||||
| Policy contract number | W0051268 | ||||||||||||||||||||||
| Policy instance | 2 | ||||||||||||||||||||||
| CALIFORNIA PHYSICIANS SERVICE (National Association of Insurance Commissioners NAIC id number: 61557 ) | |||||||||||||||||||||||
| Policy contract number | W0051268 | ||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||
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